FORM C APPLICATION FOR RENEWAL OF RECOGNITION OF MATRICULATION / MATRICULATION HIGHER SECONDARY SCHOOLS. (The Managements who have obtained permission or on expiry of Temporary Recognition may apply in this proforma with necessary enclosures - This application should be submitted to the Inspector of Matriculation Schools concerned in Duplicate Attested Xerox copies of enclosures should only be attached - not originals) Renewal of Recognition will be granted for the period upto which the stability certificate is issued. 1. Name of the School with full Address ........................... ........................... ........................... ........................... ........................... Pin : 2. Area of the School situated (Corporation, Municipality, Town Panchayat or Panchayat 3. Management Contribution (Original chalan should be enclosed) SCHOOL STRENGTH Rs. Strength of the School from LKG Amount Rs. Challan No. & Date Name of the Try. 2000 & above 1,00,000 1500-2000 80,000 1000-1500 60,000 750-1000 40,000 500-750 20,000 500 & below 10,000 4. Remittance of Application Fee (Original Chalan should be enclosed) Amount Rs. Chalan Date Name of the Try. A Manual For Matriculation Schools 87 5. Remittance of Annual Inspection Fee (Original Chalan should be enclosed) Amount Rs. Chalan Date Name of the Try. Rs. 2500 for Mariculation Schools Rs. 5000 for Matri. Hr. Sec. Schools 6. Recognition sought for Standards from ........ to ....... for The period from ........ To ....... 7. Year of the School first started 8. Date and No.of latest permission or recognition order (a copy should be enclosed) 9. Details of previous permission or recognition (order copy enclosed) (enclosing the latest order copy is essential) 1. 2. 3. 4. 5. 10. Name and Address of the Management Trust a. Whether Registered b. Date of Registration c. Place of Registration 11. Name of the other institution to which the Management of Trust running 1. 2. 3. 4. A Manual For Matriculation Schools 88 12. a. Whether the Institution is a Minority or Non-Minority b. If minority enclose a copy of the minority declaration 13. Endowment details For Sections Amount Name of the Bank deposited Date of Deposit Date of Maturity Bank Certificate No. For Matriculation School Sections 1. 2. 3. 4. 5. For Higher Secondary School Sections 1. 2. 3. 4. 5. TOTAL (Duly attested xerox copies should be furnished. Original should be shown at the time of inspection, failure of show the original at the time of Inspection will lead to rejection of the application form). 14. Corpus fund details (deposit of one month Teachers Salary) Amount Rs. Name of the Bank or Post Office Date of Deposit Account No. A Manual For Matriculation Schools 89 15. Availability of land details Total area of the land available for school including building area 1. in acres ............ 2. In Sq. ft. ........... a. Area of the Building b. Area for the play ground 16. Owner of the land a. Owner by Trust / Society / Management or Individual b. Rented or leased or owned c. If on lease, the period of lease d. If rented, the amount of rent per year e. whether it is registered or unregistered (a xerox copy of the document should be enclosed) 17. Buildings available details. Nature of Construction Total Area No. of rooms Classes functioning Office room Lab Room Library Room Computer Room Games Room RCC Ground Floor 1st Floor 2nd Floor 3rd Floor A/c Roof shed Thatched Shed Tiled Shed Tin sheet shed TOTAL 18. a. Whether all the buildings and play ground are in the same compound b. If not state the door no. and name of the street and then no of classes functioning c. If not, the distance between the main building and the play ground A Manual For Matriculation Schools 90 19. Laboratory facilities available : Common Lab Separate Labs. Common or Separate Lab Area Total value of the equipments (List need not be enclosed) Common Lab a. Physics b. Chemistry c. Biology 20. Library Facilities available Area Total volumes of the Books Total value of the books (List need not be enclosed) 21. Toilet facilities available: For Staff For Students Male Female Boys Girls Toilet Urinals (Indicate the number of Toilets and Urinals) 22. Building stability Certificate : (Attested xerox copy of the certificate enclosed) (obtained only from Chartered Engineers) Name and designation of the officer issued the certificate No and date of the certificate Certificate issued for the area Certificate for the period From To 23. Building Licence Certificate Designation of the Date and No. of the No.of Children to be Period authority issued Certificate accommodated From To 23.(a) Sanitary Certificate Authority issued Date of Certificate Period From To A Manual For Matriculation Schools 91 24. Students strength as on 01.04.2005 a. STDS BOYS GIRLS TOTAL LKG UKG TOTAL STDS BOYS GIRLS TOTAL I II III IV V b. c. d. STDS BOYS GIRLS TOTAL VI VII VIII IX X STDS BOYS GIRLS TOTAL I Group II Group III Group IV Group V Group Vocational Total STDS BOYS GIRLS TOTAL I Group II Group III Group IV Group V Group Vocational Total Grand Total (a+b+c+d+e) e. A Manual For Matriculation Schools 92 25. Teachers Particulars (Qualified Teachers means Graduate or Post graduate with B.Ed., or M.Ed., Qualification or Diploma in Teacher Education or Trained Language Teachers , Qualification or Diploma in Teacher Education or Trained Language Teachers Designation No. of Qualified Teachers No. of Unqualified Teachers P.G. Teacher B.T. Teacher S.G. Teacher Language Teacher (a list of Teachers in the Proforma should be enclosed) Sl.No. Name of the Teacher Qualification Salary Per month Whether PF scheme Available Total No. of Non Teaching Staff : 1. Clerks 2. Attenders 3. Record Clerk 4. Office Assistant 5. Watchman 6. Ayaha Total 26. Details of the conditions imposed in the previous permission or recognition order and its rectification by the Management. DECLARATION I hereby declare that the information furnished in this proforma is true and correct to the best of my knowledge. I also hereby declare that I will abide by the provisions of the code or Regulations of Matriculation Schools and the instructions of the Department, Government of Tamilnadu. Signature of the Signature of the Secretary / Manager / Principal with Date Correspondent with date A Manual For Matriculation Schools 93 Note : Remittances should be made in the following Heads of Accounts. ote : Remittances should be made in the following Heads of Accounts. a. For Matriculation school Renewal of Recognition = Rs. 1000/- Head of Accountant 002 Education Sports , Art & Culture 01 General Education 202 Secondary Education (5) Other Receipts (DPC 0202 -01 -202-AB-0505) b. For Higher Secondary Renewal of Recognition = Rs. 1000/- Head of Account 002 Education Sports , Art & Culture 01 General Education 202 Secondary Education AB Other Receipts (5) Other Receipts c. Annual Inspection Fee For Matriculation Schools = Rs. 2500/- For Matriculation Higher Secondary School = Rs. 5000/- Head of Account "2202 Education, Sports, Art and Culture -01 General Education - 102. Secondary Education - AB Other Receipts 07 other receipts (DPC 2202 -01-102-AB-0707)" A Manual For Matriculation Schools 94